International Journal of Clinical Case Reports 2017, Vol.7, No.6, 23-27
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debridement of the wound to remove the necrotic tissues. After the wound is debrided and the slough removed, the
wound is irrigated with hydrogen peroxide and antiseptic betadine solution. When the wound is secondarily
infected, broad spectrum antibiotics can be prescribed (Reddy et al., 2012). Recently, a systemic treatment with
Ivermectin, derived from avermectin, obtained from actinomycetes, has been found to be effective when given
orally in a single dose of 150 to 200 mg/kg of body weight and repeated, if required, after 24 hours (Shinohara et
al., 2004; Rossi-Schneider et al., 2007; Jain et al., 2010; Melo Nunes et al., 2010).
It acts by blocking the nerve
endings through the release of gamma amino butyric acid (GABA) leading to palsy and death of the parasite
(Shinohara et al., 2004). Bacon fat when applied on lesions prompts the larva to migrate into the fat. It may take
24 hours, however, for the larva to come-out and it may be necessary to remove the larvae with tweezers while
coming out (Caissie et al., 2008).
Need of case reporting and species identification: It is of prime importance that the causative fly larva be either
reared to adult or, preserved in 75% alcohol to identify the genus or, species. If many larvae are present, some
should be preserved and others kept live for adult rearing. Preserved larvae allow identification of family, genus,
and sometimes, the species of the infecting organism but adult specimens are much better known and therefore,
more reliable for species diagnosis, hence, it is always useful to rear the larvae to adult whenever possible. Larval
or, adult specimens should be sent to entomology or, parasitology center for authoritative identification. The
documentation of myiasis cases based on proper identification of the parasite accompanied by detailed
information on the patient’s history provides data on the epidemiology, distribution and behavior of these parasites
and thus, facilitates the diagnosis, treatment and prevention of new cases (Caissie et al., 2008).
3 Prevention
According to Rossi-Schneider T, control of the fly population is a sanitary measure that should be adopted to
reduce the occurrence of myiasis in human beings (Rossi-Schneider et al., 2007). Factors predisposing to attacks
by myiasis-producing flies include: 1) summer season; 2) contact with infested hosts or, visit of an area of infested
hosts; 3) poor hygiene and poor treatment of wounds; 4) sleeping outdoors; and 5) travel to an endemic area
(Caissie et al., 2008). The disease can be prevented by controlling the fly population and by maintaining good
personal hygiene. In this, patients with special needs including patients with mental and/or, physical disability
should be well taken care-of (Ramli and Rahman, 2002; Sheikh et al., 2011; Bhagawati et al., 2013).
References
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Kumar J.S., 2012, Oral Myiasis: A Case report, Pacific J Med Sci, 10: 47-50
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